What are the main types of aphasia?

What are the main types of aphasia?

There are eight main types of aphasia, and experts consider three main factors when determining which kind a person has. Those factors are:

• Fluency. Do they speak smoothly and easily? Does their speech have the right pace, pitch, pronunciation and grammar? Can they also write without difficulty?
• Understanding. Does the person understand what other people are saying? Do they say phrases and sentences that make sense? Can they also read and understand written words?
• Repetition. Does the person have any trouble repeating words, phrases or complete sentences?

Broca’s aphasia

Also known as “non-fluent aphasia” or “expressive aphasia,” this is one of the more common forms of this condition. People with Broca’s aphasia usually have the following:

• Loss of fluency. People with Broca’s aphasia struggle to form words. They may repeat words or simple phrases over and over (but struggle to or can’t repeat back something you say to them). People with the most severe cases can’t make any sounds (mutism) or can only make a single sound at a time.
• Understanding is not affected. People with Broca’s aphasia can’t speak, but they can still understand what other people are saying. They also can tell that something is wrong with their ability to speak.
• Struggle with repetition. Broca’s aphasia affects repetition, meaning a person with it might have trouble repeating back words or phrases you say to them.
• Other symptoms: Damage to Broca’s area, especially from strokes, often also affects a nearby part of the brain that controls muscles for movement. Because of that, people with Broca’s aphasia are more likely to have at least some paralysis on one side of their body.

Wernicke’s aphasia

Also known as “fluent aphasia” or “receptive aphasia,” this is also a relatively common form of aphasia. People with Wernicke’s aphasia usually have the following:

• Fluent speech. This means that they don’t have any trouble with the physical act of speaking. However, what they say is often confusing or doesn’t make sense. People with this may use the wrong words or make up words. Experts sometimes call this “word salad.”
• Problems with understanding. People with this struggle to understand what others are saying. They might understand very simple sentences, but the more complex the sentence or phrase, the harder it is to understand.
• Struggle with repetition. Wernicke’s aphasia affects repetition, meaning a person with it might struggle to repeat back words or phrases you say to them.
• Other symptoms. Wernicke’s area of the brain is near parts of the brain that affect your sight, so people with this kind of aphasia often have vision problems, too. People with Wernicke’s aphasia also often have anosognosia (an-oh-sog-no-zh-uh), a condition where your brain can’t recognize or process signs of a medical problem you have. That means people with this often don’t know or can’t understand that they have this kind of aphasia.

Global aphasia

This is the most severe form of aphasia. It usually involves the following features.

• Loss of fluency. People with global aphasia struggle with the physical act of speaking. People with the most severe forms of this might only make small or isolated sounds, or they might not make any sounds at all (mutism). They also may repeat words or simple phrases over and over (this is a problem with fluency, as they’ll still have trouble repeating back words or phrases you say to them).
• Problems with understanding. People with this struggle to understand what others are saying. They might understand very simple sentences, but the more complex the sentence or phrase, the harder it is to understand.
• Struggle with repetition. Global aphasia affects repetition, meaning a person with it might struggle to repeat back words or phrases you say to them.
• Other symptoms: This kind of aphasia happens with conditions that cause severe brain damage, such as major strokes or head injuries. The damage is usually severe and affects multiple parts of the brain, causing other serious symptoms like one-sided paralysis, blindness and more.

Other forms of aphasia

• Transcortical motor aphasia: This is similar to Broca's aphasia but usually not as severe. A key difference is that people with this don't have a problem repeating back phrases or sentences you say to them.
• Transcortical sensory aphasia: This type is similar to Wernicke's aphasia but usually not as severe. Like with transcortical motor aphasia above, people with this type don't have a problem repeating back what you say. This type of aphasia is common with degenerative brain conditions like Alzheimer’s disease.
• Conduction aphasia: This type of aphasia affects fluency but not understanding. People with this struggle to pronounce words, especially when trying to repeat something you say to them.
• Mixed transcortical aphasia: This aphasia is like global aphasia, except that people with this can still repeat what people say to them.
• Anomic aphasia: People with this kind of aphasia struggle to find words, especially names of objects or words that describe actions. To get around this problem, they often use several words to explain what they mean or non-specific words like "thing" instead.

Other conditions that involve or look like aphasia

• Progressive primary aphasia (PPA). Though it has “aphasia” in the name, this is actually a degenerative brain disorder. People with this condition gradually lose the ability to speak, write, read or understand what others are saying. This is different from injury- or stroke-related aphasia, which doesn’t get worse over time. Different forms of PPA happen with diseases like frontotemporal dementia and Alzheimer’s disease.
• Alexia (word blindness) and agraphia (inability to write). Damage to the parts of your brain that control your ability to speak can also affect your reading and writing abilities. People with alexia can see words but can't recognize or read them. People with agraphia lose the ability to write. These can happen at the same time, but in rare cases, people can have alexia without agraphia, meaning they can write words but then can't read what they wrote.
• Auditory verbal agnosia. This is a condition where a person can hear people speaking but can't recognize that what they hear is other people talking. It happens when there's a disruption in an area of the brain that processes sound or spoken language.